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Affidavit of Conversion

Nuay A. Malumin has sworn an affidavit stating that they are changing the vehicle registered under their name. The original vehicle was a 1991 Kawasaki TC with plate number TC-JW-2450. They are now changing it to a 2018 Honda motorcycle with engine number KYA10E047214 and chassis number KYA10047274, with side car denomination. Malumin signed the affidavit to establish the change of vehicle and comply with Land Transportation Office requirements.

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AMIDA ISMAEL. SALISA
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984 views2 pages

Affidavit of Conversion

Nuay A. Malumin has sworn an affidavit stating that they are changing the vehicle registered under their name. The original vehicle was a 1991 Kawasaki TC with plate number TC-JW-2450. They are now changing it to a 2018 Honda motorcycle with engine number KYA10E047214 and chassis number KYA10047274, with side car denomination. Malumin signed the affidavit to establish the change of vehicle and comply with Land Transportation Office requirements.

Uploaded by

AMIDA ISMAEL. SALISA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines)

City of Isabela )s.s.


X---------------------------------X

AFFIDAVIT OF CONVERSION

I, NUAY A. MALUMIN, of legal age, Filipino citizen, and a resident of


Sumagdang, Isabela City, Zamboanga Peninsula, Philippines, after having been duly
sworn to in accordance with law, hereby depose and say that;

1. I am the lawful registered owner of that certain motor-vehicle which is more


particularly described as follows;

Motor No.: 450815 Body Type: TC


Chassis No.: KB-823765 MV File No.: 0928-24364
MAKE : KAWASAKI YEAR MODEL: 1991
Plate No. : TC-JW-2450

2. However, I changed the said motor vehicle with the following details:

Engine No.: KYA10E047214 Chassis No.:


KYA10047274
SERIES: TMXS2J Denomination: W/ SIDE CAR
MAKE : HONDA Body Type: Motorcycle
YEAR MODEL: 2018 MV File No.: 0901-00000420656

3. I make these statements under oath and in good faith in order to establish the
fact that I will cause the change of the previous motor vehicle to a new one;

4. I execute this Affidavit voluntarily to attest to the truth of the foregoing facts
based on personal knowledge and in compliance with the requirement of the
Land Transportation Office, Isabela City to cause the change of denomination of
the above described motor vehicle and for whatever purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this ____ day of


August, 2020 at Isabela, Zamboanga Peninsula, Philippines.

NUAY A. MALUMIN
Affiant

SUBSCRIBED AND SWORN to before me on this _____ day of August, 2020 at


Isabela, Zamboanga Peninsula, Philippines.

ATTY. RAUDA I. SALISA


Notary Public until December 31, 2021
Notarial Commission No. 2019-04
Roll of Attorney’s No. 67609
PTR No. 3444960-4/5/2019
IBP No. 06-9846-01-01/17/2019; ZAMBASULTA
Isabela City, Basilan
Doc. No.
Page no.
Book No. XXII
Series of 2020

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